Overview

What Are Pigment Disorders?

There are many types of abnormal pigmentation, or coloring, that can occur on the skin. Many are congenital (present at birth) and others develop throughout someone’s life. Almost all are related to an excess or malfunction of melanin (pigment) produced by specialized skin cells called melanocytes.

Examples of pigment disorders include:

• Albinism: This rare disorder is caused by a lack of melanin and produces white hair and skin and light blue eyes. It is a genetic condition (runs in families).
• Vitiligo: Smooth white patches develop on the skin in response to the loss of melanocytes. It is considered an autoimmune condition, in which the immune system attacks healthy cells.
• Melasma: Symmetric butterfly-shaped patches of dark brown or grayish brown form on the face. It is often in response to pregnancy or other hormone changes.
• Moles (congenital nevi): Moles can be raised or flat, brown or black. Only the ones present at birth are considered congenital nevi. The larger they are, the greater the chance they will develop into cancer later in life.
• Café-au-lait spots: These caramel-colored, oval-shaped spots can be found anywhere on the body and often fade with age. They can be removed, but often reappear.  
• Hemangioma: Sometimes called “strawberry patch” birthmarks, these appear in the first few weeks after birth and grow until the baby is six to nine months old. Most hemangiomas gradually shrink and disappear on their own.
• Nevus flammeus (port-wine stain). This flat, pink, red or purple coloration is present at birth—often on the face, arms and legs—and the color deepens as the child ages. When they are found on the face, port-wine stains can cause vision complications. They do not disappear on their own.
• Mongolian spots: These blue or grayish bruise-like spots are usually found on the lower back or buttocks of African-American and Asian babies and fade with age.
• Post-inflammatory increase or decrease in pigmentation: After a burn, infection or other injury, skin can lose pigment or develop excessive pigmentation.
• Macular stains or salmon patches: Pink and red marks known as vascular birthmarks may be seen on newborn babies. Angel’s kisses (on the face) or stork bites (on the back of the neck) are the most common. They disappear during childhood.
• Telangiectasias: These small blood vessels may be visible through the outer layer of skin, creating a red, blue or purple coloration. They are related to spider veins present in the leg.
• Acanthosis nigricans: This condition causes patches of the skin to get dark and thick. It can be related to obesity, a side effect of medication or a warning sign for thyroid disorder or diabetes.